Treatment options for stage III bladder cancer

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My brother was diagnosed with stage three bladder cancer. He began a chemotherapy program scheduled to last three months. Within the last week he had a CT scan to determine if the cancer had spread and a visual scope of his bladder to determine the effect of the chemo. The scan showed no spreading and the scope showed no cancer. His surgeon is advising that my brother continue with the next cycle of chemo, a period of rest and then the surgery to remove his bladder. My question is this: are you aware of people who have had the "same good fortune" in regards to the above tests and who opted not to have their bladder removed. I very much appreciated any comments, etc., you may have. Keep up the good work.

Alan J. Wein, MD, Professor and chair of the Division of Urology at the University of Pennsylvania School of Medicine and Chief of Urology at the Hospital of the University of Pennsylvania, responds:

Urologic Oncologists differ in their opinion regarding the efficacy of the so-called bladder sparing protocol (combination of chemotherapy and radiation therapy), which in some cases is used to obviate the necessity of removing the bladder. It would be unusual to obviate surgery by using chemotherapy alone. There are protocols, which use chemotherapy prior to surgery, and this is the route that your brother has embarked upon. The best suggestion would be to make sure he is in the hands of a urologic oncologist (someone who has had special training in urologic cancers).

Jan 7, 2014 - The International Bladder Cancer Group has proposed a new definition of progression in nonmuscle invasive bladder cancer that is clinically useful for determining prognosis and comparing treatment options, according to research published in the January issue of The Journal of Urology.